甲氰咪胍与硫糖铝对呼吸机相关性肺炎发病的影响

THE INFLUENCE OF CIMETIDINE VERSUS SUCRALFATE ON THE MORBIDITY OF VENTILATOR ASSOCIATED PNEUMONIA

对６１例急性呼吸衰竭进行气管插管机械通气患者，分别用硫糖铝和甲氰咪胍预防应激相关性上消化道出血。观察防治效果及对呼吸机相关性肺炎（ＶＡＰ）发病率的影响。结果显示，两组患者消化道出血发生率无差异（Ｐ＞０．０５），ＶＡＰ总发生率亦无显著性差别（Ｐ＞０．０５），而晚发性ＶＡＰ发生率硫糖铝组显著低于甲氰咪胍组（Ｐ＜０．０５）。建议机械通气患者用药物预防应激相关性上消化道出血时，优先选用硫糖铝，以降低晚发性ＶＡＰ的发生率，改善急性呼吸衰竭机械通气患者的预后。

Objective:To assess the influence of the prophylaxis regimens of stress-related upper gastrointestinal hemorrhage (SR-UGIH) on the morbidity of VAP in mechanically ventilated patients with the acute respiratory failure. Methods: All cases (n=61) were randomly divided into two groups which are received respectively sucrealfate and cimetidine to protect and treat SR-UGIH. The morbidity of SR-UGIH and VAP was recorded in the two groups.Results: The morbidity of SR-UGIH was not statistically different between two groups (P>0.05). Total incidence of VAP was also not statistically different (P>0.05),but the incidence of late-onset VAP among patients who received sucralfate was statistically lower than that among patients who received cimetidine (P<0.05).Conclusion:Compared with cimetidine,sucralfate may reduce the incidence of late-onset VAP in mechanically ventilated patients with the acute respiratory failure. To improve the prognosis sucralfate may be the drug of first choice which is used to prevent and treat SR-UGIH.